Things were quiet in the ER last night until a young man, about 18 years old, walked in our back door.

This is an important thing to point out: he *walked* in. Perfectly steady, except for the “weaves” because he was quite drunk.

Why do I mention it?

Because his head had been split open from his right eyebrow to the top of his scalp.

He was drinking/partying/doing something and was attacked. He and the girl who brought him in knew who attacked him, but would not say. They were both very drunk.

For reference, the “normal” range for EtOH testing in the lab is 0 – 9 mg/dL of blood. His EtOH was 292. Not kidding. Which, according to my my diagnostic lab book, usually presents with ataxia, double vision, nausea, and vomiting. People usually go into a coma around 300 or 400.

He WALKED in.

Sorry. It boggles my mind.

OK, so he was attacked with something large and dense, like a 2×4 or something, because not only did the blow split his scalp open, it fractured his skull. In the x-ray showed a nice deep indentation in his forehead. As I started IVs in both his arms, the MD came up, lifted up the flap in his skin, and stuck his finger in the fracture, checking to see how extensive it was.

I would like to point out that I am a new nurse, and not very good at starting IVs. I was so shocked and, honestly, frightened by the severity of his injury that my hands started to shake. And, naturally, that’s when my preceptor said, “Get an IV in him.”

I grabbed a 20 gauge, set him up, and nailed it on the first try. Perfect line. Drew the labs, capped it off.

My preceptor said, “Is that a 20? Trauma patients need an 18 or larger. Get a bigger IV in him.”

Shit. So I grabbed an 18, set him up on his other arm —- and NAILED it. Perfect line.

As his girlfriend watched me do this, with my hands visibly shaking, she said, “You’re supposed to be HELPING HIM, not SHAKING!”

We all started to laugh.

He was flown to Phoenix for a CT and to get stitched up. By the time the flight crew came in to get report and tape him to a board for transport, he was starting to come down (we had fluids running him wide open). He asked me to dig his wallet out of his (completely blood covered) pants, and he handed me a little slip of paper out of the wallet.

He pointed to a phone number. “Can you call this for me?” he said.

Above the number in wobbly handwriting was one word: “Dad.”

These are fucking CHILDREN. It breaks my heart.